Moles and Blemishes

Common Skin Lesions

SEBORRHOEIC WARTS

are common with increasing age and usually present in the late 30s. Their cause is not well understood. They tend to be brown in colour and have a rough surface with a "stuck on" appearance. They are not harmful, however can be easily treated by cryotherapy (freezing) or by curettage (scraping) under local anaesthetic. They may recurr despite sucessful removal

Moles

The average adult has between 15- 40 moles, which appear between childhood and up to the age of 40 years. A mole is made of a collection of melanocyte pigment cells, which give the mole its colour.

Moles are normal and appear in childhood. The more sunlight a child is exposed to can increase the number of moles. Some families have many moles on the skin, which is normal for those family members as the number of moles is under the control of genes.

Illustrated here are a few normal moles, which can be flat or raised.

SEBACEOUS CYSTS

are caused by blockage of the sebaceous gland of the hair follicle. They usually present as smooth firm swellngs in the skin and can become intermittently infected (red and sore). Common areas are the face, neck, chest and scalp. Treatment usually involves surgical removal under local anaesthetic, which leaves a linear scar behind.

COMMON PIGMENTATION BLEMISHES

Lentigo are sometimes called freckles or age spots and are the result of cumulative damage to the skin by sunlight. They are usually flat spots with increased pigmentation. The edges are seldom uniform and the pigmentation tends to vary from light to dark in different lesions.

MELASMA

appear as dark irregular but well defined areas of increased pigmentation on the cheeks, nose, upper lip and forehead. It particularly affects pregnant women and those taking hormonal contraceptives or HRT. Melasma is thought to be caused by stimulation of melanocytes by the female sex hormones (oestrogen + progesterone). There may also be genetic tendancy and association with thyroid disease.

Treatment

Surgical removal under local anaesthetic is a simple and effective procedure that takes 30 minutes. This usually produces a satisfactory aesthetic result with minimal scarring.

Common Vascular Blemishes

Thread veins

are usually a sign of UV damage to the skin but can also be hereditary and may be associated with pregnancy, especially in the legs. They are extremely common and harmless, however may look unslightly. Thread veins are readily treatable with microsclerotherapy injections which block the veins, preventing blood flow and causing them to shrink away. Another option is IPL + laser treatment which is effective but may require more treatment sessions.

Rosacea

is a common facial condition affecting over 45 million people worldwide. It mainly affects fair skinned individuals of both sexes between age 30-60. It presents with flushing and redness of the central face (cheeks / nose / forehead) and can progress to lumps and pustules forming in the skin. It is commonly mistaken for acne and dermatitis, althought they can co-exist. Triggers can include anything that causes flushing and blushing (eg. alcohol / caffeine / hot and spicy foods).

Haemangiomas

are generally divided into 2 types; those that are present from birth (eg strawberry naevus) and those that appear later in life (eg spider naevus as shown below). They are caused by a collection of fine superficial blood vessels which produce a characteristic red skin lesion. They are either congenital or caused by skin ageing, pregnancy and liver disease. Most haemangiomas are readily treatable with electrosurgery or IPL / laser.

Skin Cancer

Moles that change in colour, size, shape or surface may represent skin cancer and should be assessed by a doctor. There are 3 main types of skin cancer, all of which are caused by sun exposure

Basal Cell Carcinoma (BCC)

is the most common form of skin cancer and usually presents as a lump just under the skin. Sometimes there is a characteristic "rolled edge" and this may later break down to form a "rodent ulcer". Surgical excision is usually an effective treatment although regular review and high factor sunscreen is recommended subsequently.

Squamous Cell Carcinoma (SCC)

is the second most common form of skin cancer and tends to present on sun exposed areas of the body (face, arms, hands). It appears more superficially and scaly than BCC and can often occur at a site of previous skin damage. Small tumours can be surgically removed but larger lesions may require cryotherapy (freezing) or fluorouracil cream (cell cycle slowing).

Malignant Melanoma

affects 6000 people in the UK every year and causes 2000 deaths annually. It can appear like a normal mole initially but if left untreated, can then spread to other parts of the body. The main features tend to be change in colour (darker), size (>6mm), border (irregular) and surface (uneven). Any such changes should be seen by a doctor, as surgical removal is simple and effective in the early stages of melanoma.

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Dr Acquilla can tailor and deliver a treatment plan that suits your individual goals, he understands the emotions that are attached to age-related changes in your appearance and endeavour to make your experience a positive one.